﻿{% extends "base.html" %}

{% block content %}

<script language=javascript>

function verify(form){
  if(form.status.value==""){
	alert("Choose status plz!");
	form.status.focus();		
       return false;
	}
	 if(form.remarks.value==""){
	alert("Enter remarks please");
	form.remarks.focus();		
       return false;
	}

return true;
 }

</script>


<table width="100%" border="0" cellpadding="0" cellspacing="0">
  <tr>
    <td align="center">
<form name='form1' id='form1' action="/add_fs/" method='post' onsubmit='return verify(this);'>
<table width='650' class='grid' cellspacing='1' align='center'><tr><td colspan='2' class='title'>Add Follow_up</td></tr>
<tr valign='middle' align='left'></tr>


<tr valign='middle' align='left'><td class='odd' width='25%'><font color="red">*</font>status:</td>
<td class='even'><select name="status">
<option value="">Choose status plz</option>
<option value="1" {% ifequal finfo.status "1" %}selected{% endifequal %}> Cannot be reached</option>
<option value="2" {% ifequal finfo.status "2" %}selected{% endifequal %}> Appointment scheduled</option>
<option value="3" {% ifequal finfo.status "3" %}selected{% endifequal %}> Under consideration</option>
<option value="4" {% ifequal finfo.status "4" %}selected{% endifequal %}> Please call later</option>
<option value="5" {% ifequal finfo.status "5" %}selected{% endifequal %}> Schedule conflict/next time</option>
<option value="6" {% ifequal finfo.status "6" %}selected{% endifequal %}> Don't call again</option>
<option value="7" {% ifequal finfo.status "7" %}selected{% endifequal %}> Enrolled</option>
</select>
</td></tr>

<tr valign='middle' align='left'><td class='odd' width='25%'><font color="red">*</font>Remarks</td>
<td class='even'><textarea name="remarks" cols="50" rows="8">{{finfo.remarks}}</textarea></td></tr>


<input type="hidden" name="m_id" value="{{m_id}}" />
{% if finfo.id %}
<input type="hidden" name="id" value="{{finfo.id}}" />

{%endif%}
<tr valign='middle' align='left'><td class='odd' width='25%'></td>
<td class='even'>&nbsp;<input type='submit' class='button' name='submit'  id='submit' value=' Submit '  />&nbsp;&nbsp;<input type='button' class='button' name='back'  id='reset' value=' Back ' onclick="javascrip:history.back(1)" /></form></td></tr>

</table>


{% endblock %}